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Baig AAM, Ansari B, Ahmed SI, Ishaque F, Farooqui WA. Association of demographics, lumbar active range of motion and disability in chronic low back: a baseline data analysis of a randomized controlled trial from Pakistan. BMC Musculoskelet Disord 2024; 25:489. [PMID: 38909184 PMCID: PMC11193308 DOI: 10.1186/s12891-024-07613-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 06/20/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND The disability and significant economic costs accredited to Low back pain (LBP) are likely to rise which is an essential problem in low and middle-income countries like Pakistan. The associated factors of LBP are age, sex, and race including physical activity, high spinal load, lifting, bending, and twisting occupations. The literature highlighted there is substantial differences in associated factors of LBP within available studies in developing countries. The objective is to investigate the association of demographic factors and lumbar range of motion with disability in patients with chronic low back. METHODS A baseline data analysis was performed as an analytical cross-sectional study among 150 patients with chronic low back in a randomized controlled trial with a duration from March 2020 and January 2021. After recording demographics, Modified-Modified Schober's test was used to measure lumbar flexion and extension and Oswestry disability index for disability. After the descriptive analysis the continuous variables, age and pain were analyzed with Spearman's correlation. Variables that were significant in bivariate analysis were then fitted in a multivariable linear regression. The Kruskal-Wallis test was used to analyze variations of disability in gender, marital status, work status, education level, and duration of pain. The p-value of 0.05 was significant. RESULTS The results showed a significant correlation between age and pain in sitting (rh=-0.189, p = 0.021 and rh = 0.788, p < 0.001) with the disability but no significant effects of age and pain in sitting (B=-0.124, p = 0.212 and B = 1.128, p = 0.082) on disability were found. The decrease in lumbar flexion and extension was found to increase disability (B=-6.018 and - 4.032 respectively with p < 0.001). Female gender (x2(1) = 15.477, p = < 0.001) and unmarried marital status (x2(1) = 4.539, p = 0.033) had more disability than male gender and married marital status, respectively. There was a significance between groups of the duration of pain regarding disability (x2 (2) = 70.905, p < 0.001). Age, education level, and work status showed no significance (p > 0.05). CONCLUSIONS The female gender and unmarried marital status are associated with functional disability. Decreased lumbar range of motion accompanies more disability, while age, education level, and work status do not effect on disability.
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Affiliation(s)
| | - Basit Ansari
- Department of Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Pakistan
| | - Syed Imran Ahmed
- Faculty of Health Sciences, Iqra University, North Campus, Karachi, Pakistan
| | - Farhan Ishaque
- Department of Physiotherapy, Dow Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
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de Oliveira Grigorini AE, Pereira LSM, Koes B, da Silva SLA, Chiarotto A, Felício DC, Leopoldino AAO. Does the intensity of pain and disability affect health-related quality of life of older adults with back pain? Multilevel analysis between Brazil and Netherlands: a cross-sectional study of the BACE consortium. BMC Geriatr 2024; 24:230. [PMID: 38443807 PMCID: PMC10916242 DOI: 10.1186/s12877-024-04803-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/12/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The prognosis of back pain (BP) in the older adults is less favorable than in younger adults and progress to adverse outcomes and consequent worsening of health-related quality of life (HRQoL). The present study aimed to verify the association between BP intensity, disability and HRQoL in older adults residents in Brazil and Netherlands, and to evaluate whether the country of residence influences the associations. METHODS Data were collected from 602 Brazilian and 675 Dutch participants with a new episode of BP from the Back Complaints in Elders (BACE) consortium. For the present study, a cross section was used. Pain intensity and disability were assessed using the Numerical Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ), respectively. HRQoL was assessed using the Short Form Health Survey (SF-36) quality of life questionnaire. Age, sex, and education were descriptive variables. Pain intensity (NPS score) and country were the independent variables and quality of life assessed by each SF domain - 36 was the dependent variable. Analysis of models at the individual level was performed to verify the association between pain and disability, also HRQoL in Netherlands and Brazil in the total sample. The multilevel model was used to verify whether the older adults person's country of residence influenced this relationship. RESULTS The average age of the participants was 67.00 (7.33) years. In the total sample, linear regression analysis adjusted for sex and age showed a significant association between BP intensity scores and HRQoL, for all domains. There was no association between disability and HRQoL. In the multilevel analysis, there was an association between BP intensity and HRQoL in all domains and an association between the country of residence and HRQoL, influencing the effect of pain, in all domains, except for the physical functioning. CONCLUSION Socioeconomic and cultural aspects of different countries can affect the perception of the elderly about their HRQoL in the presence of BP. Pain and disability in Brazilian and Dutch older adults ones are experienced differently in relation to their HRQoL.
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Affiliation(s)
- Adriana Estela de Oliveira Grigorini
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, 275 Alameda Ezequiel Dias, 30130-110, Belo Horizonte, Minas Gerais, Brazil
| | - Leani Souza Máximo Pereira
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, 275 Alameda Ezequiel Dias, 30130-110, Belo Horizonte, Minas Gerais, Brazil
- Department of Physical Therapy, Graduate Program in Rehabilitation Science, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bart Koes
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Diogo Carvalho Felício
- Department of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Amanda Aparecida Oliveira Leopoldino
- Postgraduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, 275 Alameda Ezequiel Dias, 30130-110, Belo Horizonte, Minas Gerais, Brazil.
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de Amorim JSC, Rocha VTM, Lustosa LP, Pereira LSM. Use of healthcare services and therapeutic measures associated with new episodes of acute low back pain-related disability among elderly people: a cross-sectional study on the Back Complaints in the Elders - Brazil cohort. SAO PAULO MED J 2021; 139:137-143. [PMID: 33825772 PMCID: PMC9632518 DOI: 10.1590/1516-3180.2020.0414.r1.0712020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Patients with low back pain frequently undergo a variety of diagnostic and therapeutic interventions, but some of these have uncertain effectiveness. This highlights the importance of the association of healthcare services and therapeutic measures relating to disability. OBJECTIVE To analyze the use of healthcare services and therapeutic measures among Brazilian older adults with disability-related low back pain. DESIGN AND SETTING Observational cross-sectional study on baseline assessment data from the Back Complaints in the Elders - Brazil (BACE-B) cohort. METHODS The main analyses were based on a consecutive sample of 602 older adult participants in BACE-B (60 years of age and over). The main outcome measurement for disability-related low back pain was defined as a score of 14 points or more in the Roland Morris Questionnaire. RESULTS Visits to doctors in the previous six weeks (odds ratio, OR = 1.82; 95% confidence interval, CI 1.22-2.71) and use of analgesics in the previous three months (OR = 1.57; 95% CI 1.07-2.31) showed statistically significant associations with disability-related low back pain. The probability of disability-related low back pain had an additive effect to the combination of use of healthcare services and therapeutic measures (OR = 2.57; 95% CI 1.52-4.36). The analyses showed that this association was significant among women, but not among men. CONCLUSIONS Occurrence of the combined of consultations and medication use was correlated with higher chance of severe disability among these elderly people with nonspecific low back pain. This suggested that overuse and "crowding-in" effects were present in medical services for elderly people.
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Affiliation(s)
- Juleimar Soares Coelho de Amorim
- PhD. Physiotherapist and Associate Professor, Physical Therapy Course, Instituto Federal de Educação Ciência e Tecnologia do Rio de Janeiro (IFRJ), Rio de Janeiro (RJ), Brazil.
| | - Vitor Tigre Martins Rocha
- MD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Lygia Paccini Lustosa
- PhD. Physiotherapist and Associate Professor, Postgraduate Program on Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Leani Souza Máximo Pereira
- PhD. Physiotherapist and Associate Professor, Postgraduate Program on Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
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O'Hoski S, Kuspinar A, Richardson J, Wald J, Brooks D, Goldstein R, Beauchamp MK. A Tool to Assess Participation in People With COPD: Validation of the Late Life Disability Instrument. Chest 2021; 159:138-146. [PMID: 32882248 DOI: 10.1016/j.chest.2020.08.2079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/13/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Participation in life roles is a critical patient-centered health outcome associated with morbidity and mortality in older adults, but it is not measured routinely in people with COPD. We aimed to validate a participation measure, the Late Life Disability Instrument (LLDI), in people with COPD. RESEARCH QUESTION To what extent does the LLDI demonstrate test-retest measurement error and reliability, internal consistency, construct and face validity, and floor or ceiling effects when applied to people with COPD? STUDY DESIGN AND METHODS In this cross-sectional study, LLDI scores were compared with scores on measures of theoretically related constructs and between groups based on symptom severity, prognosis, and frailty. A subsample (n = 36) completed the LLDI a second time over the phone within one week. Participants and health-care professionals were asked about the relevance, comprehensiveness, and comprehensibility of the LLDI. Floor and ceiling effects were explored, and the internal consistency (Cronbach's α) of the LLDI was calculated. RESULTS Ninety-six older adults with COPD participated. The frequency and limitation domains of the LLDI showed excellent test-retest reliability (two-way random effect intraclass correlation coefficient, 0.90 [standard error of measurement, 1.74 points] and 0.90 [standard error of measurement, 3.16 points], respectively). Both domains showed fair correlations with physical function, depression, and quality of life (r = 0.38-0.59). The relationship with anxiety was poor for the LLDI frequency domain (r = -0.21) and fair for LLDI limitation domain (r = -0.45). Both domains discriminated between people with different symptom severity, prognosis, and frailty (P ≤ .026). Neither domain showed floor or ceiling effects, and Cronbach's α was 0.69 and 0.91 for the LLDI frequency and limitation domains, respectively. All healthcare professionals and most participants agreed that the LLDI measures participation (79%) and that the items were relevant (81%). INTERPRETATION The LLDI shows test-retest reliability, internal consistency, and construct and face validity in people with COPD. The LLDI can be used to assess participation in this population.
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Affiliation(s)
- Sachi O'Hoski
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Joshua Wald
- Firestone Institute for Respiratory Health, St. Joseph's Health Centre, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Rehabilitation Sciences Institute and Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Roger Goldstein
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada; Rehabilitation Sciences Institute and Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Marla K Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; Firestone Institute for Respiratory Health, St. Joseph's Health Centre, Hamilton, ON, Canada; Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
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Jung H, Chae H. The Safety and Efficacy of Methocarbamol as a Muscle Relaxant with Analgesic Action: Analysis of Current Data. INNOVATIVE BIOSYSTEMS AND BIOENGINEERING 2019. [DOI: 10.20535/ibb.2019.3.4.183336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Saes MDO, Lopes JDN, Nunes BP, Duro SMS, Facchini LA, Thumé E. [Occurrence of spinal disorders and associated factors among the elderly: a population study in a municipality in the deep south of Brazil]. CIENCIA & SAUDE COLETIVA 2019; 26:739-747. [PMID: 33605348 DOI: 10.1590/1413-81232021262.33542018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/29/2019] [Indexed: 01/05/2023] Open
Abstract
The scope of this study was to estimate the prevalence of spinal disorders among the elderly and analyze potential associated factors. It involved a cross-sectional study of a sample of 1,593 elderly individuals aged 60 years or more residing in the urban area of Bagé, State of Rio Grande do Sul. In addition to the "spinal disorders" outcome, demographic, socioeconomic and behavioral variables, health perception, functional activities and the use of health services were investigated. Data collection was conducted by means of face-to-face interviews. Poisson regression analysis with robust variance was used to verify the factors associated with the outcome analyzed. Of the 1,593 participants, 37.4% reported spinal disorders. The factors related to the outcome were: low level of schooling, poor self-assessment of health, consultation in the last three months and the presence of hypertension, rheumatism and fractures. Interventions for musculoskeletal health can contribute to reduce the damages caused by spinal disorders among the elderly, such as loss of functional capacity, increased demands for health care and reduced quality of life.
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Affiliation(s)
- Mirelle de Oliveira Saes
- Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Campus da Saúde. 96203-900 Rio Grande RS Brasil.
| | | | - Bruno Pereira Nunes
- Faculdade de Enfermagem, Universidade Federal de Pelotas (UFPel). Pelotas RS Brasil
| | | | | | - Elaine Thumé
- Faculdade de Enfermagem, Universidade Federal de Pelotas (UFPel). Pelotas RS Brasil
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Pérez-Ros P, Martínez-Arnau FM, Orti-Lucas RM, Tarazona-Santabalbina FJ. A predictive model of isolated and recurrent falls in functionally independent community-dwelling older adults. Braz J Phys Ther 2018; 23:19-26. [PMID: 29914855 DOI: 10.1016/j.bjpt.2018.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 05/03/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Aging is associated with an increased risk of accidental falls. Falls in older people have been widely studied in nursing homes and in the elderly with poor functionality, but there have been few investigations into functionally independent community-dwelling older adults. OBJECTIVE To determine the predictive factors for falls in functionally independent community-dwelling older adults. METHODS A cohort trial-nested case-control study was carried out. The participants were community-dwelling people aged 70 and over who were treated in primary care centers from December 2012 to May 2014 in la Ribera (Valencia, Spain). RESULTS There were a total of 374 participants, with a mean age of 76.1 (SD 3.4) years (63.8% females). The subjects presented high functionality scores: Barthel 96.5 (SD 9.4), Lawton 7.2 (SD1.2), Tinetti 25.6 (SD 3.3). The mean number of prescribed drugs was 4.7 (SD 2.9). The cumulative incidence of falls was 39.2%, and 24.1% of these older adults suffered falls. The number of falls in the previous 12 months (OR=1.3; 95%CI: 1.11-1.53; p<0.001) and alpha-blockers (OR=6.72; 95%CI: 1.62-27.79; p=0.009) were predictors of falls. The presence of previous fractures (OR=9.55; 95%CI: 4.1-22.25; p<0.001), a body mass index of ≥30kg/m2 (OR=1.09; 95%CI: 1.01-1.19; p=0.035), and who are using benzodiazepines and beta-blockers (OR=2.77; 95%CI: 1.53-5.02; p<0.001), were predictors of recurrent fallers. CONCLUSIONS Older people who use alpha-blockers, benzodiazepines and beta-blockers, had previous fractures, with increased body mass index are more likely to fall.
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Affiliation(s)
- Pilar Pérez-Ros
- Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.
| | - Francisco M Martínez-Arnau
- Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain; Department of Physiotherapy, Universitat de València, Valencia, Spain
| | - Rafael M Orti-Lucas
- Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain; Department of Preventive Medicine, Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - Francisco J Tarazona-Santabalbina
- Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain; Department of Geriatrics, Hospital Universitario de la Ribera, Valencia, Spain
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